Tuesday, January 29, 2019

Canada's Food Guide: New dish, with a dash of condescension

After years of celebrating our agricultural know-how, the guide has gone urban - and is more than a little patronizing

By Sylvain Charlebois
Senior Fellow
Atlantic Institute for Market Studies
Sylvain Charlebois
Sylvain Charlebois
Say goodbye to the four food groups.
Almost 12 years after the launch of the previous version, the new Canada's Food Guide celebrates food by displaying a plate filled with greens, fruits, plant proteins and grains. And if you look very carefully, you'll see a cup of yogurt alongside a piece of beef that looks a little like a piece of wood.
Unlike the old version, the new guide can apply to different demographic groups and lifestyles.
In a somewhat less innovative vein, it also encourages Canadians to cook, eat with other people, and consider water as their drink of choice.
In all, the new food guide is a bold move from Health Canada, but it still misses the mark in some areas.
The plate concept is clever. Few Canadians could tell how big portions should be in the old version and many can relate to the size of a plate.
Dominated by vegetables and fruits, grains and proteins are now sidekicks. And, as expected, animal-based proteins are now second fiddle to plant-based proteins. Dairy and meat products have lost the protein wars, which means that in Ottawa, Health Canada won over Agriculture and Food Canada, probably for the first time.
Nutrition-conscious minds prevailed, for better or worse.
The guide has always showcased our agricultural know-how, beginning with the first edition in 1942. Then, not only did almost 30 per cent of our population live on farms, but nearly 30 per cent of our national gross domestic product came from agriculture. It was expected that the government promote commodities grown in our backyard. That guide displayed products we all knew: milk, fish and meat.
Now, less than two per cent of Canadians live on farms and agriculture represents a fraction of our national GDP.
The tone of this new guide is different as well - it embraces a different language: the nutrient-focused jargon Health Canada believes Canadians are ready for.
Fibre and proteins are at the core of this new publication. The guide has gone urban for the first time. It's more contemporary, multicultural and adaptable to varying modern diets.
It's about time.
For the Liberal government heading into an election in the fall, this city-friendly platform will do no great harm, only alienating regions that historically support the Conservatives.
There are some weak points in this new guide, though. Some of it is quite condescending, with trite advice only an idealistic health professional would give. Phrases like "Enjoy your food," "Be mindful of eating habits," and the patronizing "Be aware of food marketing" are prominent.
As the guide became more sophisticated about what we should be eating, it also got a little smug, treating all Canadians like five-year-olds. The food industry spends billions on marketing and the average Canadian sees roughly 1,500 advertisements a day. Is Health Canada suggesting Canadians can hide from all of this for the sake of eating better?
That's a stretch.
And in the new guide, Health Canada is at odds with the buy-local movement.
Eggs, poultry and milk are by far the biggest losers. Supported by supply management, our grandiose protectionist policy that allows us to produce what we need, these sectors may end up overproducing in just a few years. As we institutionalize a new message, behaviours will change. Domestic production of these commodities may require recalibration soon and many of our farms could disappear.
Our agricultural trade policies aren't synchronized with our domestic food policies and the new guide will only make things worse. Ottawa can't carry on stating it unconditionally supports supply-management policy. It clearly doesn't anymore.
On the fruit and vegetable front, things could get tricky as well. We're highly vulnerable due to our dependency on imported fruits and vegetables, especially in winter. It's the most volatile food category for consumers. For example, lettuce prices went up by a whopping 39.4 per cent over 12 months in Canada. These price shifts are hard for consumers to cope with.
We need to raise our veggie game in Canada - fast.
So the new food guide is a step forward, despite the dash of demeaning comments.
Now if we can get Health Canada to review the guide every five years like most other industrialized nations, perhaps it will stop treating the release like it was revealing the location of Cleopatra's tomb.
Sylvain Charlebois is scientific director of the Canadian Agrifood Foresight Institute, a professor in food distribution and policy at Dalhousie University, and a senior fellow with the Atlantic Institute for Market Studies.

Friday, January 25, 2019

Wrinkle Injections: Vegan Millenials refuse Botox

Wrinkle Injections: Vegan Millenials refuse Botox:

The main ingredient in Botox is botulinum toxin, produced by Clostridium botulinum bacteria.  Although the main ingredient in Botox comes from bacteria, since another ingredient is from humans, 
Botox is not vegan.

 Not only is Botox made of a non-vegan ingredient, the injectable is also tested on animals.

Botox and Fillers. As most fillers, including lip and derma fillers, are made from non-animal origin hyaluronic acid, they are considered vegan
However, much like Botox, they are required by law to be tested on animals because they're classified as medical products.

Anyone born between 1981 and 1996 (ages 23 to 38 in 2019) is considered a Millennial

Thursday, January 24, 2019


The caramel process must be watched. Do not walk away. Do not answer the door. Do not begin to empty the top rack of dishwasher. Stay put. Keep watch. Sugar is sneaky. I’ve had the best results without using a candy thermometer, so standing watch in order to see the color change can mean the difference between a smooth result or an over-burnt sticky clump.
Have all the ingredients and tools needed ready to go. Since a watchful eye is required, and the end of the process moves quickly, there won’t be a bunch of time to calmly gather everything.
Avoid stirring. Stirring can trigger crystals to form. Crystals are the enemy of smooth caramel. The recipe below follows the wet caramel technique. Once the sugar dissolves in the water, don’t stir until it’s ready to add other ingredients.
Make sure all tools being used for cooking are clean. Crystals can be triggered by any impurities.
Make sure to use a saucepan/pot that has tall enough sides for the amount to double as it will bubble and foam up toward the end. It will get very hot! So splattering is not a good thing. A heavy-duty, non-coated saucepan or skillet with tall sides will work well.
The recipe below lists refined granulated sugar. Other sugars, like brown sugar, can be used as well, but it can be tricky to get consistent results due to impurities. If you choose to try it with something other than refined granulated sugar, be extra vigilant.
David Lebovitz is quite the expert on caramel. Check out his tips and tricks for making caramel. AND be sure not to miss his Salted Butter Caramel Ice Cream recipe. Oh my … it’s worth all the effort. It’s the best!
Don’t give up. If you botch a batch, try again! You will learn with each attempt and begin to see the pattern. You’ll become a caramel making champ in no time.
Salted Caramel Sauce

This Salted Caramel Sauce is the perfect addition to so many treats. It refrigerates and rewarms well too.
Recipe type: Dessert
Serves: Makes a little over 2 cups.

Tuesday, January 15, 2019

The wisdom (or lack of) in prescribing opiates after tooth removal A mother and a dentist team call for an end to routine opioid use for teens after wisdom tooth removal

By Amy Ma
and Susan Sutherland
We're writing as a parent and a dentist to spread a message to parents and dental health-care providers across Canada: there are alternatives to prescribing opioids after wisdom teeth removal.
Removing wisdom teeth is considered by many as a rite of passage for teenagers. It's one of the most common surgical procedures done in young people aged 16 to 24.
Amy Ma
Amy Ma
Amy's 16-year-old son, Felix recently had his wisdom teeth removed. After surgery, the surgeon's assistant advised that to "stay on top of the pain," Felix should take a Percocet right away. Percocet is a combination of the pain reliever, acetaminophen and an opioid, oxycodone. The assistant provided him with enough Percocet to take every three hours for the next day.
Thankfully, Amy knew of the possible harms associated with powerful opioid medications, such as Percocet, especially for young people. Abuse of opioids is a national public health emergency, with growing numbers of opioid overdoses and deaths.
So she asked the surgeon's assistant whether there was another pain management option for Felix. Tylenol 3 was suggested (acetaminophen with the opioid codeine), which still seemed too powerful.
How did Amy know to question the advice she was given?
Susan Sutherland
Susan Sutherland
Amy serves as the patient adviser for the national campaign Choosing Wisely Canada, which partners with national clinician societies to develop lists of tests, treatments and procedures that may cause harm. So she knew that the Canadian Association of Hospital Dentists recommends non-opioid based pain medications to be prioritized following dental surgery and to resort to opioids only if the pain can't be managed.
Amy asked for Naproxen for Felix - an over-the-counter pain reliever in the same drug class as Aspirin and Ibuprofen. Felix took the Naproxen as directed when the anesthesia wore off and he didn't require anything stronger. In fact, he was quite comfortable.
We need to think twice about whether an opioid prescription is needed after wisdom teeth removal.
After having her wisdom teeth removed, Lady Gaga posted pictures of her puffy face and tweeted out to her millions of followers: "Wisdom teeth out. P-p-Percocet p-p-Percocet." Percocet after minor oral surgery should not be an expectation of teenaged patients.
What's at stake?
Persistent opioid use after elective surgery, like wisdom teeth removal, is a risk, especially in young people whose brains are developing and are highly susceptible to the effects of opioids. Leftover opioids are equally dangerous for teens, who might be tempted to experiment or share with friends and family members.
Dentists and oral surgeons have a critical role to play here - they're among the leading prescribers of opioids to young people. An American study published recently found that dentists are the leading source of opioid prescriptions for children and adolescents aged 10 to 19 years in the United States. Dental prescriptions account for over 30 per cent of all opioid prescriptions in this age group.
This study also found that young people who received opioid prescriptions after wisdom tooth extraction were more likely to be using opioids three months and one year later, as compared to their peers who didn't get an opioid.
The evidence is clear: a short prescription for opioids poses a real risk of ongoing opioid use to our teenagers.
Many patients experience pain and swelling lasting three to four days and sometimes up to a week after wisdom teeth surgery. The intensity and duration of these symptoms varies considerably depending on the position of the teeth, how deeply they're buried in bone and the surgical difficulty in removing them. While many oral surgeons and dentists prescribe opioids routinely after dental surgery, pain management for all patients should be handled individually.
In most cases, post-surgical dental pain can be controlled without opioids and through anti-inflammatory drug such as ibuprofen, in combination with the non-opioid pain relievers such as acetaminophen. For some oral surgery procedures, such as such deeply impacted wisdom teeth or jaw reconstruction, an opioid may be needed for pain control for a short time.
It's time oral surgeons and dentists move away from a one-size-fits-all pain management strategy. Avoiding unnecessary opioid prescriptions for teenagers is critical part of staving off the harm of the opioid epidemic.
Amy Ma is a parent of three living in Montreal. She is the co-chair of the family adviser forum at the Montreal Children's Hospital and patient adviser to Choosing Wisely Canada. Dr. Susan Sutherland is the chief of dentistry at Sunnybrook Health Sciences in Toronto. She is the president of the Canadian Association of Hospital Dentists.

Tuesday, January 8, 2019

Safety Pin Clutch

Safety Pin Clutch

This is the most talked-about silhouette from BODHI and has been featured every where from Gossip Girl to the Glamourai. The signature safety pin hardware accents this perfectly sized clutch, making this bag a huge statement wherever you go. The Interior is completed with two cell pockets and one zip pocket.



• Signature BODHI Safety Pin Handle. 
• 2 Mobile Phone Pockets. 
• 1 Zipping Accessory Pocket.

Friday, January 4, 2019

Quebec's health-care privatization a lesson for the whole nation But much still hinges on the outcome of the ongoing court case in B.C.

By Amélie Quesnel-Vallée
and Rachel McKay
Ask a random Canadian if our health system looks more like that of the United States or the United Kingdom. Chances are, most will respond that our system is nothing like the U.S. - which is largely paid for privately - and every bit like the U.K., which has publicly-funded health care.
The reality is more of a cold shower.
Amelie Quesnel-Vallee
Amelie Quesnel-Vallee
When we look at data from the Organization for Economic Co-operation and Development (OECD), which compares the wealthy countries of the world, we see that Canada is well ahead of most peer countries in terms of private financing, with a whopping 30 per cent of our health expenditures paid for through private health insurance or out-of-pocket spending.
This is 50 per cent more than the U.K., where private health spending is at 20 per cent, and three times as much as in France, where it's only 10 per cent.
Now, a court case that is ongoing in British Columbia, known widely as the Cambie case, has some worried that we might see an even greater development of the private pay health-care market across Canada.
But will we?
The Quebec experience suggests that a lot hinges on how forcefully and decisively the B.C. government responds to the court challenge. And, on this count, B.C. has a head start where Quebec faltered. The court decisions matter, of course but, at the end of the day, it will be provincial governments' actions (or lack thereof) that open or shut the door to a two-tier health system.
For those with good memories, the Cambie case may be oddly reminiscent of the Chaoulli case that unfolded more than 13 years ago in Quebec.
To understand both, it's worthwhile to remind readers of the legal provisions that constrain the private purchase of health care in Canadian provinces. Basically, doctors in Canada are prohibited from extra-billing or double dipping - charging patients for services already covered under our publicly funded medicare.
Rachel McKay
Rachel McKay
Doctors are also prohibited from working in both the public pay and the private pay health system at the same time, when providing medicare beneficiaries with publicly insured services. The concern is that such a dual practice could result in a conflict of interest, creating wait times in the public system to funnel patients to the more lucrative private practice.
Physicians must choose: either be all in the public system or all out.
The Cambie court challenge seeks to break down the all-in or all-out dilemma for physicians, striking at the heart of BC's Medicare Protection Act by targeting all constraints on extra-billing and opted-out practice, dual practice and private insurance that duplicates B.C.'s public plan.
The Chaoulli court challenge was far less ambitious, targeting only Quebec's legal prohibition on the purchase of private insurance for services delivered by opted out physicians. Yet, at the time, this was still perceived as significant risk for the development of a two-tier system.
Many were concerned when Jacques Chaoulli won his challenge, and Quebec responded with Bill 33, which opened the door to duplicative private insurance for a select number of otherwise publicly-insured health services.
While Bill 33 turned out to be fairly innocuous (largely because private insurers didn't deem this a profitable venture and that it only applied to Quebec), it nevertheless responded to the spirit of the court challenge, sending a powerful message that Quebec's elected officials were at least, in principle, supportive of more private health provision and insurance.
The Chaoulli case should really be seen as a symptom rather than a cause of the fact that Quebec is home to what is arguably one of the largest private health markets in the country. In fact, the cause stems more from neglect by legislators - whether benign or strategic, and for decades preceding Chaoulli - allowing several hot spots of privatization to flourish.
This includes private diagnostic services, which are reimbursable by private insurance in Quebec but not elsewhere in Canada; physicians opting out of the public system in ever increasing numbers, year after year; and extra-billing, which was only been officially banned by the province in 2017 (only after threats of claw backs of the federal health transfer).
While B.C. shares similar historical trends with Quebec, we see no such benign neglect by B.C. legislators.
Instead, the B.C. government appears to be fighting tooth and nail in the face of Cambie, pulling out all the stops to buttress the Medicare Protection Act. It even resurrected 14-year-old Bill 92, the Medicare Protection Amendment Act, in a deft counterpunch to give the province more powers to crack down on extra-billing.
With both sides firmly entrenched in their positions, it's unlikely that we will see a swift resolution to the Cambie conflict. Whichever side loses the court case is likely to bring it to the B.C. Court of Appeal and, from there, to the Supreme Court of Canada, as happened with Chaoulli.
In other words, there's still a long battle ahead.
Amélie Quesnel-Vallée is the Canada Research Chair in Policies and Health Inequalities and the director of the McGill Observatory on Health and Social Services Reforms at McGill University. She's also a contributor with EvidenceNetwork.ca, which is based at the University of Winnipeg. Rachel McKay is a post-doctoral fellow with the McGill Observatory on Health and Social Services Reforms at McGill University.